Mental Health and Addiction Ad Hoc Agenda 10/08/2019Mental Health and Addiction Ad Hoc Committee Workshop
October 8, 2019 – 8:30 am – 12:30 pm
Collier County Museum – Main Campus
3331 Tamiami Trail E.
Naples, FL 34112
1.Call to Order
2.Pledge of Allegiance
3.Roll Call
4.Adoption of the Agenda
5.Public Comment
6.Adoption of Minutes from the September 27th Meeting
7.Staff Reports
7.1. Review of Remaining MHAAHC Dates and Workshop
7.2. Introduction of Mark Englehardt
8.New Business
8.1. Draft Committee Report Review
8.2. Existing Committees and Future Recommendations (Sean Callahan)
9.Old Business
10.Public Comment
11.Announcements
12.Committee Member Discussion
13.Next Meeting Time, Date and Location
12.1. October 22, 2019 – 8:30 am – 10:00 am – Collier County Museum
14.Adjournment
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MINUTES OF THE REGULAR MEETING OF THE COLLIER COUNTY
Mental Health and Addiction Ad Hoc Committee Meeting
September 24, 2019
Naples, Florida
LET IT BE REMEMBERED that the Collier County Mental Health and Addiction Ad Hoc
Committee met on this date at 8:30 A.M. at 3331 Tamiami Trail East, Main Campus Museum,
Naples, Florida with the following Members Present:
Mental Health Committee
Present:
Not Present:
Lt. Leslie Weidenhammer
Scott Burgess
Council Member Michelle McLeod
Pat Barton
Trista Meister
Janice Rosen
Dr. Paul Simeone
Caroline Brennan
Dr. Jerry Godshaw (Phone)
Dr. Michael D’Amico
Michael Overway
Dr. Thomas Lansen (Phone)
The Honorable Janeice Martin
Dr. Pam Baker
Susan Kimper (Phone)
Russell Budd (Phone)
Reed Saunders (Phone)
Dale Mullin
Also Present: Sean Callahan – Executive Director-Corporate Business Operations
Heather Cartwright-Yilmaz – Sr. Operations Analyst
Katina Bousa, Director, Inmate Services, Collier County Jail
1.Call to Order & Pledge of Allegiance
Chairman Scott Burgess called the meeting to order at 8:38 A.M. and led the Pledge of
Allegiance.
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3.Roll Call – Committee Members
Seventeen (17) members of the Mental Health and Addiction Ad Hoc Committee were present,
representing a quorum.
4.Adoption of the Agenda
A motion was made for the adoption of the agenda and it was approved.
5.Public Comment
There was no public comment.
6.Adoption of Minutes from Previous Meeting
A motion was made and amended minutes from the previous meeting were approved.
7.Staff Reports
7.1 Review of Remaining MHAAHC Dates and Workshop
Committee discussion ensued around remaining schedule. The October 8th meeting will be a
longer session as a page by page project review. The October 22nd meeting will be for
preparation and rehearsal.
Discussion then ensued around the Adhoc Committee sunset and Workshop on October 29th.
8.New Business
8.1 Draft Committee Report (Chet Bell – not included in agenda packet)
Chairman Burgess introduced Chet Bell.
Mr. Bell and Mr. Englehart plan to be at the October 22nd meeting.
Committee discussion ensued around the formal name of the Committee with the correct use
being consistent throughout the document – “The Collier County Mental Illness and Addiction
Ad Hoc Advisory Committee.” The Committee agreed that the wording should match the
resolution.
The Committee agreed a PowerPoint presentation document be created that has powerful
graphics with pictures. The PowerPoint will include a picture of the Committee at work with
the plan. It was recommended the PowerPoint presentation be the presentation instrument
during the Workshop that will include the full report. The Report/White Paper will include
bullet points rather than narrative with clear and concise message throughout to include graphs,
charts and infographics for added interest. Mr. Bell lead discussion about introductory section
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to include Committee members and its charge with acknowledgement for services. The
appendix will have introductory section with an acknowledgement for the Community
Foundation, funding and services.
Mission Statement: Discussion ensued around the mission statement.
“The Committee will collaboratively plan and support a coordinated effort for a full array of
evidence informed services and support to improve the lives of individuals with mental health
and substance abuse disorders and overall quality of life in Collier County.”
PP 2 last paragraph: Without losing fundamental meaning, simplify points. Mr. Bell will
bullet this area.
PP 3 2nd paragraph. Recommended bullet points or sub headers under priorities. Mr. Bell
will review section to ensure that not repetitive. Last year’s plan in appendix, can be distilled
to a summary. Sustainability and depth to be trimmed down to 2-3 key words with broad
overview from last year’s plan with rank order.
PP 3 3rd paragraph: In its plan SAMHSA identified 5 priorities. The agency that seeks funding
from the state. The simplicity of language with referencing. Reference same approach.
When we reference number include written number.
Recommended language: In its investigation the Committee considered models from agency
that allocates funding. Mr. Bell will do some work with this.
Last paragraph pp 3 and 1st PP4: Confirmed recommendations and ranking on priorities.
Last paragraph on pp 4: Mission Statement and List of priorities being bolded. Do a sub
header here: bolding, headers or callouts. Public must be able to read in 5 minutes or less.
Special Consideration: Bold Veteran, bold Veteran Services, Seniors and Special Needs
(evidence-based practices) to draw components in there. This report identifies…needs to be
bolded or stand out for public take home on this.
Discussion ensued around Veterans and Seniors with unique needs and unique resources. Use
different language for special considerations for evidence based. Recognized that Committee
seen veterans as unique and recommended to include a paragraph. Must craft language to
apply to the unique needs and unique resources for Veterans and Seniors.
Mr. Bell updated the paragraph for evidence-based practices, seniors and veterans. The
following recommendation was made: “Special attention must be paid to the unique needs of
our veterans’ population and all activities related to these priorities. The Committee also
received input from the public regarding special needs population of seniors.”
The Committee ensued discussion around creating a 3rd special considerations for evidence-
based practices, seniors and veterans. Add adult to the mission statement and remove
individuals. To improve the lives of adults with substance abuse issues. Use language in
resolution.
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PP5: Throughout priorities there is some inconsistency. Include: Priority statement,
overview, objective, outcome, impact and data element to effect outcome and impact...
Priority 1: Best example of what we want and how we want them to read. Please take this in
mind as we review them.
The discussion ensued around the priority and overview. Priority 1: Central Receiving
Facility: Do we want to continue the Priority Statement? Ensure that all have components
identify why, needs, problems with remedy. Put as many bullet points with statistics.
PP 5 paragraph 2 Overview: The Marchman act is either treated at the jail or at the NCH and
neither facility is built…. Susan Kimper will send data that want to have included to integrate
into the plan.
The need had already been established and will be included in the appendix. We want this to
be very concise and action oriented. The previous work needs to be included in appendix with
a paragraph. Include stats in the appendix as we did previously.
Remember that we are also recommending data collaborative. Update data in earlier report to
be included. Provide data that supports these priorities. This information will also be included
in the PowerPoint. The document that was written last year will be included as addendum with
current data with appendix.
Additional Items:
1. Update data in earlier report
2. Ensure that Presentations made on the 29th, provide data that support priority that we use
in PowerPoint presentations.
Priority 1: Infrastructure Surtax Citizen Oversight Committee…will give good scrub.
The Committee recommended realistic timeframe for the Central Receiving Facility to be
completed and services be operating by end of 2022.
4th Paragraph: Too much language.
Recommending simplifying to: “The legislature funded awards for central receiving systems
to three Florida communities as part of pilot.”
Committee discussion ensued around extending the October 8th meeting. Mr. Bell and Mr.
Englehart will likely be in Collier County for the October 8th meeting from 8:30-12:00.
Committee: Look at specific areas, wordsmith, break things out, bullet points, add data, come
prepared. Consider PowerPoint language for specific areas.
Mr. Bell will summarize and will incorporate into document. Mr. Englehart will take the lead
and massage the document. The way you want to modify document. Get the changes to Sean
and he will get the information to Mr. Bell and Mr. Englehart. Continue to provide feedback.
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Get changes/updates to Sean by Monday, October 30th. Sean will add feedback and note it as
such to Mr. Bell and Mr. Englehart. Separate document and will be added into document.
Judge Janeice Martin will help with wordsmithing and other items as needed.
Discussion ensued around Priority 2: The work product had the correct information.
Committee discussion ensued around the Overview describes the need and eliminate the
Priority Statement. Make sure that overview has the right information.
8.2 Existing Committee and Future Recommendations (Sean Callahan)
The Committee reviewed the list provided by Sean. The BCC will approve/deny plan during
Board meeting in November/December. In early 2020, integrate the plan into another
Committee. Establish oversight committee as continued effort and coordination for plan.
Chamber or Community foundation may be great mechanism for completion. Having
collaboration with key areas that community identified as major priorities: Mental Health,
Senior Services, Affordable Housing. Major issues that public is not aware of various issues.
Recognize that community does not know and reinforce message for consistencies. Review
priorities give recommendations on a quarterly basis. Continue to have meetings with county
staff to ensure that plan is met for oversight to ensure plan is completed.
9.Old Business
There was no business on the agenda besides the workshop agenda.
10.Public Comment
Mike: Service Members and Families for Veterans Council. Was invited by Dr. Baker.
Reviewed special considerations. The Veterans suicide, PTSD will not be able to drive 3 of
the critical points. Objectives, reduced veterans’ suicide, note that data not available for CC.
Recommended that coroner note and report to CDC and VA on Veteran Suicide. When data
is reviewed for homeless, do not expect that homeless will come to you. Must go to them.
Start support group for Veterans only November 7th with NAMI. Florida lost 512 to suicide
since 2017. Florida is number one state for veteran suicide and will send report to Dr. Baker.
He sits on Lee County called Community Health Improvement Plan. CHIP
The speaker suggested that other important minority groups were left off, including LGBTQ,
elderly, veterans that are 55 above. He also recommended special consideration be granted to
help identify and help the families. Care givers for veterans are now large group that commit
suicide. Will get report to Dr. Baker for Sean Callahan to share with Committee.
11.Announcements
The Committee agreed to have group picture taken on October 8th. Heather Cartwright-
Yilmaz set that up.
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12. Committee Member Discussion
There was no further discussion.
13. Next Meeting Time, Date and Location
October 8, 2019 – 8:30-12:00 pm – Collier County Main Museum
14. Adjournment
The meeting adjourned at 10:20 am with nothing further left to discuss.
Collier County Mental Health and Addictions Ad Hoc Advisory Committee
Scott Burgess – Chairman
The foregoing Minutes were approved by Committee Chair on October 8, 2019, “as submitted” [
] or “as amended” [ ]
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Collier County Mental Illness and Addiction Ad Hoc Advisory Committee
Report to the Collier County Commission
Mental Health and Addiction Services
5 Year Strategic Plan
2020-2024
Add picture of the committee at work in introduction
A few infographics for each priority – i.e. Baker Acts annually
Need for powerpoint presentation for submission to County
Submitted October 29, 2019
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Committee Origin, Membership, and Charge
On December 11, 2018 the Collier County Board of County Commissioners approved
Resolution 2018-232 establishing the Mental Illness and Addiction Ad Hoc Advisory
Committee. The Advisory Committee was charged to make recommendations
regarding the County’s role in providing assistance and treatment of adults with mental
health and substance use disorders.
The Resolution required that Committee membership not exceed 19 individuals
appointed by the Board with consideration given to ensure geographic and background
diversity. Special qualifications for membership included:
• representative designated by a Veteran services organization;
• representative designated by the Collier County Sheriff’s Office;
• representative designated by a Collier County grantor entity which provides
funding to providers of services for mental illness and substance abuse use
disorders for adults;
• psychiatrist, licensed to practice in Florida;
• behavioral health professional, licensed to practice in Florida;
• medical health professional;
• representative from a homelessness advocacy organization;
• representative of the David Lawrence Center, Inc.;
• representative from the National Alliance on Mental Illness;
• a certified peer specialist;
• representative from the recovery community;
• representatives from the local business community; and,
• representatives at-large with experience or demonstrated interest in mental
illness and substance use disorders.
The Resolution defined the purpose of the Committee to include “providing input from all
entities involved in providing assistance to, and the treatment of, persons with mental
health or addiction issues, both public and private, as well as members of the public, to
identify existing mental and behavioral health services issues in the community to
ensure the inclusion of all possible services, treatment, and public and p rivate
assistance for county residents struggling with mental illness and/or substance abuse
disorders.”
The Committee would like to acknowledge the support of the Community Foundation of
Collier County for their generous financial support to hire outside consulting services in
support of completion of this plan.
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Mission Statement
The Committee adopted the following mission statement:
“The Committee will collaboratively plan for and support a coordinated effort for a full
array of evidence informed services and supports to improve the lives of adults with
mental health and substance use disorders and overall quality of life in the Collier
County community.”
Collier County Committee Work and Report Development
The Mental Illness and Addiction Ad Hoc Advisory Committee was organized and
convened for the first time on January 4, 2019. Ultimately the Committee met 21 times
over the course of the year, including 18 regular meetings and 3 half day workshops to
organize the information included in this report.
The Committee utilized its meeting time to gather information and develop strategies to
implement the priorities established in the Mental Illness and Substance Abuse
Strategic Plan submitted to the Board of County Commissioners in June 2018 and
included as an appendix to this report. External subject matter experts made
presentations to the Committee on issues related to Housing, Veteran Services and the
design of a Data Collaborative. The knowledge gained from study of those priorities
was applied in 4-hour planning workshops held on August 10, September 12 and
October 8. During these workshops the Committee restated those priorities and
established the goals, objectives and a logic model for the implementation of each
priority that follow in this report.
In preparing this report the Committee used the format employed by the Substance
Abuse and Mental Health Services Administration (SAMHSA) in its most recent
Strategic Plan. SAMHSA is the federal agency that promotes a vision for the United
States behavioral health care system, establishes national policy directives along with
other Federal partners and allocates Mental Health and Substance Abuse funding to
states and local communities through block and discretionary grant programs. In the the
spirit of Recovery, the Committee recognizes SAMHSA’s working definition of recovery
from mental disorders and/or substance us disorders that was developed by dozens of
stakeholders as: “A process of change through which individuals improve their health
and wellness, live a self-directed life, and strive to reach their full potential”. There are
four major dimensions that support a life in recovery: Health, Home, Purpose and
Community. With those four pillars, there are 10 Guiding Principles of Recovery:
1. Recovery emerges from hope
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2. Recovery is person-driven
3. Recovery occurs via many pathways
4. Recovery is holistic
5. Recovery is supported by peers and allies
6. Recovery is supported through relationship and social networks
7. Recovery is culturally-based and influenced
8. Recovery is supported by addressing trauma
1. Recovery involves individual, family and community strengths and responsibility
9.
2. Recovery is based on respect
10.
. This report attempts to replicates SAMHSA’s approach, then summarizes our
recommendations for each priority through the use of a logic model.
This report identifies six (6) priorities that we recommend receive ongoing attention and
support by the Board of County Commissioners over the next five years. Some
priorities will require substantial financial support, while others will require little funding,
but will require the involvement of County staff working in collaboration with community
partners.
The priorities, ranked in order of their relative importance by the Committee, are:
1. Build and Operate a Central Receiving Facility/System to Serve Persons
Experiencing an Acute Mental Health or Substance Use Crisis
2. Increase Housing and Supportive Services for Persons with Serious Mental
Illness and/or Substance Dependence
3. Establish a Mental Health and Substance Use Disorder Data Collaborative for
Data Sharing, Collection and Outcomes Reporting
4. Increase the Capacity and Effectiveness of Justice System Response for
Persons Experiencing Serious Mental Illness and/or Substance Use Disorders
5. Revise and Implement Non-Emergency Baker Act and Marchman Act
Transportation Plans
6. Improve Community Prevention and Advocacy Related to Mental Health and
Substance Use Disorders
Bold Mission, Bold Priorities, Bold veterans and Evidence Based Practices
Special Considerations
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The Committee identified two populations that we recommend receive special
consideration in all actions related to these priorities. Specific attention must be paid to
the unique needs of Veterans in all activities related to these priorities, ensuring that
there is easy access to treatment and specialized programs to assist Veterans
experiencing Post Traumatic Stress Disorder and Traumatic Brain Injury both in
community programs and from the Veteran’s Administration.
The Committee also received input from the public regarding the special needs of
Senior Adults, particularly those in cognitive decline who experience profound changes
in their behavior and emotional stability as a result of their illness. These individuals
require specialized care very different from that provided in Baker Act Receiving
Facilities that primarily treat individuals in crisis from a mood or thought disorder.
In addition, all services, programs and activities related to the identified Priorities and
special populations must be grounded in the best available Evidence Based or
Evidence Informed Practices in order to ensure maximum quality and cost
effectiveness in services provided to the community.
On the following pages find the Committee’s recommendations regarding our Priorities,
including Goals, Objectives and Outcomes anticipated for each. Logic models for each
Priority are also provided, offering an “at a glance” overview of the inputs required,
activities to be conducted and outcomes anticipated for each Priority.
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Priority #1
Build and Operate a Central Receiving Facility/System to Serve Persons
Experiencing an Acute Mental Health or Substance Use Crisis
Overview: A central receiving system consists of a designated central receiving facility
and other services providers that serve as a single point or a coordinated system of
entry and treatment for individuals needing evaluation or stabilization under section
394.463 (Baker Act) or section 397.675, (Marchman Act) Florida Statutes, or crisis
services as defined in subsections 394.67(17)-(18), Florida Statutes.
It should be noted that currently there is no provision for involuntary evaluation or
stabilization under the Marchman Act unless a secure Addictions Receiving Facility is
funded. Due to this service deficiency all persons requiring such services are treated at
the Collier County Jail, a facility neither designed nor appropriate for that purpose. The
Collier County Community Needs and Assets Assessment (2017) noted the need for
additional inpatient beds and more than 80% of its health focus group participants
identified mental health and substance use issues as major public health problems
The Collier County Municipal Infrastructure One-Cent Sales Surtax will provide $25
million to build a new facility that will house these services and increase capacity. While
the Surtax will provide the infrastructure necessary to expand capacity, additional funds
will be required to provide the human resources and other ongoing operational costs
associated with the central receiving system.
Funding to support operations, estimated to $2 Million and $3 Million annually, will
require both state and county funding. In 2016-2017 the Florida Legislature authorized
the Department of Children and Families to support central receiving systems and
awarded funding to 3 Florida communities. A Legislative Budget Request closely
aligned with the requirements of the FY 16-17 appropriation and support with matching
dollars from Collier County appears to be a logical approach for obtaining the needed
operational funds.
Goal: Ensure that there is a coordinated system and adequate capacity to assure that
citizens in crisis will be able to access emergency mental health and substance use
disorder services over the next 20 years.
Objectives:
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•Design, build, staff and operate Central Receiving Facility/System including an
access center and follow up recovery-oriented treatment services in the
community Services by 2022
•Assure sustainable funding to ensure ongoing Central Receiving operations over
the next 20 years.
•Provide both Co-occurring Baker Act (Crisis Stabilization) and Marchman Act
(Detoxification) services as part of Central Receiving Facility/SystemServices.
•Explore the feasibility of providing primary integrated healthcare at the new
facility
Outcome/Impacts:
•Increased access to mental health and substance use disorder crisis care
•Improved crisis care by offering a full range of mental health and substance use
crisis services and by providing direct linkage and a warm hand off to community-
based services following crisis care
•Reduced law enforcement processing time for an immediate drop off
•Provide appropriate jail diversion options and services
•Reduced transfer time from local hospitals
•Improved patient satisfaction with access to and quality of care in crisis services.
Data elements required to assess outcome and impact:
•Episode of care data;
•Baker Act and Marchman Act Data – Both public and private facility data from
residents and non-residents of Collier County
•Law enforcement time in drop off data;
•Hospital transfer referral data;
•Crisis Intervention Team (CIT) data
•Jail Diversions as a result of the Central Receiving System
•ClientPatient satisfaction questionnaire at discharge
Workgroup: Scott Burgess, Susan Kimper
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Priority #2
Increase Housing and SupporiveSupportive SerivesServicest for Persons with
Serious Mental Illness and/or Substance Dependence
Overview: For people with mental health and substance use disorders, housing is
considered a ‘golden thread’, providing the foundation through which all aspects of
treatment and recovery are possible. When this basic need isn’t met, people cycle
tragically in and out of homelessness, jails, shelters, and hospitals at a high cost to
individuals and society. The Urban Land Institute’s 2017 report on housing, land use
and real estate issues in Collier noted that an area of concern was the lack of residential
mental health care and support services. Further, the recent Collier County Needs
Assessment Survey identified Housing as the number one community need in th e
county. While this need extends beyond those with severe mental illness or substance
dependence, the housing shortage exacerbates the problem for these especially
vulnerable individuals.
Due to low incomes (typically less than $800 per month), discrimination, and difficulties
in daily functioning, persons with serious mental illnesses and substance use disorders
generally cannot compete for market rental housing. Additionally, affordable housing
units and supported housing programs have long wait lists and few in need can access
them when in need.
To be successful, housing supports should follow evidence-based and evidence-
informed practices, including the use of the SAMHSA Permanent Supportive Housing
Tool Kit ; a ‘Housing First’ philosophy and model in which housing is a right, not a
privilege; eligibility is not dependent on psychiatric treatment compliance and sobriety;
and housing units are integrated within the community. An array of options should
include rental assistance vouchers, rapid re-housing, recovery housing, transitional
housing, peer run respite, and permanent supportive housing, each bundled with
appropriate levels and choices of services and supports.
Goal 1: Increase availability and accessibility of a variety of housing options and
supportive services for persons with mental health and substance use disorders.
Objectives:
•100% of all Collier County approved affordable housing will include the
required 10% set aside for persons with a dedicated portion for mental health
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and/or substance use disorder, which may require Board of County
Commissioners action.
•Increase number of private landlords accepting rental assistance vouchers.
•Increase number of supportiveed housing and supported employment
provider agencies.
•Increase individual incomes beyond disability amounts to ensure long term
stability.
•Ensure supported housing rents are limited to 30% of the individual’s income.
•Implementation of a high fidelity Permanent Supportive Housing Evidenced-
based program
Goal 2: Homelessness among persons with mental health and substance use disorders
is rare, brief and one-time.
Objectives:
•100% of chronically homeless who are diagnosed with a severe mental health
disorder will be housed within x days of enrollment in coordinated entry.
•100% homeless individual will have immediate access to low-barrier
emergency shelter
•100% of persons with a serious mental health disorders identified annually
during the Point in Time count will not meet the definition of chronically
homeless.
•Increase number of SOAR (SSI/SSDI Outreach, Access and Recovery)-
trained staff and # dedicated staff hours to facilitate attainment of Social
Security benefits for eligible individuals.
Outcomes/Impact:
•Increased nNumber of affordable housing units available to persons with a
mental health and/or substance use disorder.
•Increased nNumber of persons receiving rental assistance/low income
housing/housing voucher
•Increased nNumber of persons attaining SSI/SSD and accompanying Medicaid
or Medicare benefits
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•Increased nNumber of peerof peer specialists employed in variety of roles in
mental health and substance use programs
•Increased number Number of days that housing residents are stably housed in
the community
•Increased number Number of days that housing residents worked for pay
Data elements required to assess outcome and impact:
•Number of agencies/providers;
•Increased capacity/number of available housing units;
•Number of hours of supportive services provided;
•Number of persons or months on housing wait lists;
•Number of persons who are chronically homelessness identified during annual
Point in Time count;
•County annual housing report,
•State SAMH data system;
•Drug Court Case management system;
•Number of people accessing supportive housing upon reentry from county jail
and mental health or veterans treatment court
•Local data collaborative reports.
•Cost effectives report on permanent supportive housing after implementation
•Qualitative analysis from the residents served in supportive housing services;
individual and focus group methods
Workgroup: Dr. Pam Baker, Cormac Giblin, Dr. Jerry Godshaw, Michael Overbay
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Priority #3
Establish a Mental Health and Substance Use Disorder Data
Collaborative for Data Sharing, Collection and Outcomes Reporting
Overview
Chapter 163.62 F.S authorizes governmental and certain private agencies to share information.
The mission of a mental health and substance use disorder data collaborative would be
enhancing the delivery of mental health programs to Collier County residents by encouraging
communication and collaboration among all related community providers, organizations,
interested government agencies, and educational institutions. Potential partners would include ,
among others, the Collier County Board of County Commissioners, Clerk of Circuit Court,
Collier County Sheriff Office, the XXXX Judicial Circuit Court of Florida, Central Florida
Behavioral Health Network, David Lawrence Center, Collier County Schools, Florida
Department of Juvenile Justice, and the he Louis de la Parte Florida Mental Health Institute
(FMHI), a part of the University of South Florida (USF) Department of Mental Health , Law and
Policy (Louis de la Parte Florida Mental Health Institute), would be the primary members of the
collaborative.
Goal: Create a data collaborative that will collect and analyze data from all stakeholders that
provide services to persons experiencing a mental health and/or substance use disorder and
use that information to continuous improve program quality and patient outcomes.
Objectives:
•To inform the planning and delivery of mental health and substance use
prevention and treatment among all related community organizations. Multiple sources
will collect internal data and share with other entities, providing a process for
comprehensively using relevant data, both at the system and clinical levels,
•Collect aAggregate data for use in planning, quality improvement, program
evaluation, and grant applications. A repository, along with staff, is required to maintain,
aggregate, and disseminate reporting on the data collected.
Outcomes/Data:
A centralized data collaborative could collect information from entities including the David
Lawrence Center, National Alliance on Mental Illness, hospitals, courts, law enforcement,
community providers, including but not limited to:
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•Numbers and demographics of persons served by each cross-system and
provider
•Calculation of the cost or persons served by each payer system, DCF, Medicaid,
County Jail, Medicare/Medicaid, Department of Corrections, housing etc. provider
•Demonstration of cost avoidance in criminal justice involvement through jail
diversion and reentry activities
•Justification for efficient distribution of public funding
•Number of days acute care units are at or over capacity
•Other metrics used to gauge effectiveness and efficiencies of the community
health system
Action Items:
•Start with a list of data points we would like to report on – including frequency, length of
treatment, outcomes, granularity, and sophistication of data efforts can be leveraged
from those employed in other communities;
•Consult with the USF Department of Mental Health, Law and Policy about existing data
collaboratives and permissions necessary to access public dataWork backward to
outline who was needed to participate in the collaborative and what specific data was
necessary;
•Draft MOUs for each participating entity surround collection and distribution of data;
•Establish a steering committee to guide the project development;
•Design a project plan to establish the database to house collaborative data;
•Begin to collect data and report on a routine basis.
Workgroup: Sean Callahan, Dr. Gerry Godshaw, Michael Overway
Formatted: Not Highlight
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Priority #4
Increase the Capacity and Effectiveness of Justice System Response for Persons
Experiencing Serious Mental Illness and/or Substance Use Disorders
Overview: Persons with mental health disorders and/or substance use disorders are at
disproportionate risk to experience involvement with the criminal justice system.
Predictably, traditional justice responses such as jail or prison have done little to
address what is ultimately a treatable medical problem. Communities have been
frustrated by poor outcomes among this population in traditional justice settings, as
persons with these disorders have cycled in and out of jails at great expense, with no
discernible benefit to the individual or the community.
Enter the Problem-Solving Court movement, now an international effort, which began
when Miami-Dade County created the first drug court in 1989. The Problem-Solving
Court model has evolved to recognize certain key components, and corresponding
standards have been developed to ensure that all courts incorporate those components.
Simply stated, the model involves a multi-disciplinary team, led by a judge, serving a
targeted population within the criminal justice system which has an identifiable and
serious need for treatment intervention. The team aims to identify, as early in the
process as is possible, those persons in the justice system for whom a program of
intensive treatment, supervision and accountability can reasonably be expected to end
the justice involvement successfully, restore the individual to wellness and self-
sufficiency, and facilitate a lasting recovery from the disorder(s) that contributed to the
criminal conduct in the first place.
The Supreme Court of Florida has promulgated standards for drug courts, and is
preparing to promulgate standards for mental health courts and veteran treatment
courts. Additionally, the Supreme Court is working on a certification process for these
courts, which will ensure fidelity to the promulgated standards and maximize chances
for the best possible outcomes across a variety of populations in the state. Further, the
Legislature has created a dedicated and recurring funding source for these courts,
which funding is expected to be tied into the upcoming certification process.
Now is a time for significant advancement of these powerful courts, and communities
are wise to commit themselves to positioning their courts to take advantage of these
developments for the best possible service of their population’s needs. Collier County
has long been a leader among counties in this regard, and has had a drug court since
1999, a mental health court since 2007, and a veteran treatment court since 2012.
11.3.b
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Significant steps need to be taken in order to ensure the sustainability of these courts,
as well as to continue to grow and improve them.
In addition to problem solving courts, there are a variety of related and complimentary
opportunities for increasing the capacity and effectiveness of the justices system’s
response to this population. Persons with mental health and substance use disorders
are not only disproportionately represented in the criminal divisions of the justice
system, but also in the family, domestic violence and dependency divisions. Expanding
behavioral health training for judges and practitioners within each of these divisions will
ensure that persons in need of treatment will be assisted in accessing it, and outcomes
overall will benefit from this holistic approach.
Priority #4
Increase the Capacity and Effectiveness of Justice System Response for Persons
Experiencing Serious Mental Illness and/or Substance Use Disorders
Overview: Persons with mental health disorders and/or substance use disorders are at
disproportionate risk to experience involvement with the criminal justice system.
Predictably, traditional justice responses such as jail or prison have done little to
address what is ultimately a treatable medical problem. Communities have been
frustrated by poor outcomes among this population in traditional justice settings, as
persons with these disorders have cycled in and out of jails at great expense, with no
discernible benefit to the individual or the community.
Enter the Problem-Solving Court movement, now an international effort, which began
when Miami-Dade County created the first drug court in 1989. The Problem-Solving
Court model has evolved to recognize certain key components, and corresponding
standards have been developed to ensure all courts incorporate those components.
Simply stated, the model involves a multi-disciplinary team, led by a judge, serving a
targeted population within the criminal justice system which has an identifiable and
serious need for treatment intervention. The team aims to identify, as early in the
process as is possible, those persons in the justice system for whom a program of
intensive treatment, supervision and accountability can reasonably be expected to end
the justice involvement successfully, restore the individual to wellness and self-
sufficiency, and facilitate a lasting recovery from the disorder(s) that contributed to the
criminal conduct in the first place.
The Supreme Court of Florida has promulgated standards for drug courts, and is
preparing to promulgate standards for mental health courts and veteran treatment
courts. Additionally, the Supreme Court is working on a certification process for these
courts, which will ensure fidelity to the promulgated standards and maximize chances
11.3.b
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for the best possible outcomes across a variety of populations in the state. Further, the
Legislature has created a dedicated and recurring funding source for these courts,
which funding is expected to be tied into the upcoming certification process.
Now is a time for significant advancement of these powerful courts, and communities
are wise to commit themselves to positioning their courts to take advantage of these
developments for the best possible service of their population’s needs. Collier County
has long been a leader among counties in this regard, and has had a drug court since
1999, a mental health court since 2007, and a veteran treatment court since 2012.
Significant steps need to be taken in order to ensure the sustainability of these courts,
as well as to continue to grow and improve them.
In addition to problem solving courts, there are a variety of related and complimentary
opportunities for increasing the capacity and effectiveness of the justices system’s
response to this population. Collier’s Criminal Justice, Mental Health and Substance
Abuse (CJMHSA) Planning Council recently completed an update of its strategic
priorities based on the Sequential Intercept Model. Problem solving courts typically are
found at Intercept 3. Additional selected priorities and their Intercept points recently
identified by the Planning Council include:
Intercept 0: Community Services - Central Receiving System operational funding;
Supportive Housing, MHIT/Mobile Crisis Unit expansion
Intercept 1: Law Enforcement and Emergency Services - Misdemeanor diversion
Intercept 2: Initial Detention and Court Hearings - Clinical Assessment and transfer
to Central Receiving services when indicated
Intercept 3: Jails and Courts - Medication Assisted Treatment for all; In-jail mental
health unit
Intercept 4: Re-Entry - Warm hand-off to co-located MHSA/Primary Care Unit
Intercept 5: Community Corrections - Supportive Probation/Parole/Pre-trial;
Medication Assisted Treatment sustainability
Maximizing the services provided at each intercept point will maximize the capability of
the justice system to utilize its leverage to serve more people and improve their
behavioral health outcomes.
Goal: Expedite deflection and diversion of persons with mental health and/or
substance use disorders prior to arrest and from jail to treatment, thereby reducing
recidivism, improving community safety and directing resources to optimize outcomes.
Goal: Expand trauma-informed and trauma-responsive practices to all divisions of the
justice system, and incorporate the use of court-supervised clinical assessments and
treatment plans as appropriate in each division.
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Objectives:
• Ensure the sustained commitment of dedicated resources from each of the
disciplines represented on the multi-disciplinary teams for each problem-solving
court
• Ensure the achievement and maintenance of certification status for each
problem-solving court, so that stable funding can be obtained and the overall
sustainability of these courts can be secured
• Ensure the collection and analysis of robust data in connection with the operation
of the problem-solving courts so that proper periodic evaluation and adjustment
of the courts can be made to optimize efficacy, and so stable funding can be
obtained and maintained
• Expand capacity of existing problem-solving courts, including the case
management services to support persons served by the court in the community
• Increase the accuracy and speed with which all incarcerated persons are
screened for mental health and substance use disorders
• Ensure that incarcerated persons who have been identified as having mental
health and substance use disorders are referred to appropriate jail-based or
community-based treatment services, as appropriate, and that they are referred
promptly to an appropriate jail diversion program or problem-solving court
• Expand capacity of jail diversion programs for persons with the most severe and
persistent mental health disorders, including the case management services to
support persons served by the court in the community
• Implement medication assisted treatment in Collier County Jail, and ensure
continued access to same in the community upon re-entry, regardless of whether
an individual is involved with a problem-solving court or diversionary program.
• Increase training for judges, attorneys, probation officers, investigators, case
managers, law enforcement officers and all other justice personnel in the causes
and treatment of both mental health and substance use disorders, and in topics
related to trauma, adverse childhood experiences, and trauma-informed and
trauma-responsive practices.
• Encourage judges across all divisions to employ trauma-informed practices in
addressing parties who come before them, and to ensure that courts are set up
to be trauma-responsive whenever possible.
Outcomes/Impacts and Data elements required to assess outcome and impact:
11.3.b
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• Reduce number of arrests;
• Increase number of incarcerated persons who are screened for mental health
and substance use disorders
• Identify the number of people with co-occurring mental health and substance use
disorders, also in need of primary health care
• Conduct an analysis of the number of people served by the court who have
health care or are indigent
• Improve symptoms;
• Improve child and family reunifications with supports;
• Reduce time between removal of at-risk or dependent children from parents and
reunification of the family unit
• Increase number employed;
• Increase number receiving additional education and training;
• Increased independence and self-reliance;
• Maintenance of sobriety - number of days sober;
• Reduce relapse rates;
• Increase medication adherence rates;
• Reduce time between arrest and screening for mental health and substance use
disorders;
• Reduce time between arrest and referral to an appropriate problem-solving court
or diversionary treatment program;
• Increased stable housing;
• Reduced number of arrests/rearrests;
• Increased number of treatment services;
• Increased number of appropriate referrals into diversion;
• Increased capacity of each diversionary court program;
• Increased graduation rates;
• Increased pathways to treatment (new programs)
• Reduce the number of adverse childhood experiences for children of adults
involved in the justice system, and increase opportunities to build resilience for
them;
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Workgroup: Judge Janeice Martin, Trista Meister, Janice Rosen,
Goal: Expedite deflection and diversion of persons with mental health and/or
substance use disorders prior to arrest and from jail to treatment, thereby reducing
recidivism, improving community safety and directing resources to optimize outcomes.
Objectives:
• Expand capacity of existing therapeutic courts, including the case management
services to support persons served by the court in the community
• Implement medication assisted treatment in Collier County Jail
Outcomes/Impacts and Data elements required to assess outcome and impact:
Reduce number of arrests;
Identify the number of people with co-occurring mental health and substance use
disorders, also in need of primary health care
• Conduct an analysis of the number of people served by the court who have
health care or are indigent
• Improve symptoms;
• Improve child and family reunifications with supports;
• Increase number employed;
• Increase number receiving additional education and training;
• Increased independence and self-reliance;
• Maintenance of sobriety - number of days sober;
• Reduce relapse rates;
• Increase medication adherence rates;
• Reduce time between arrest and connection with treatment;
• Increased stable housing;
11.3.b
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• Reduced number of arrests/rearrests;
• Increased number of treatment services;
• Increased number of appropriate referrals into diversion;
• Increased capacity of each diversionary court program;
• Increased graduation rates;
• Increased pathways to treatment (new programs)
Workgroup: Judge Janeice Martin, Trista Meister, Janice Rosen,
Formatted: Centered
11.3.b
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PPriority #5
Revise and Implement Non-Emergency
Baker Act and Marchman Act Transportation Plans
Overview: In the continued best interest of persons in need of public behavioral
healthcare in Collier County, there is a need to establish a non-emergency
transportation plan for individuals receiving involuntary evaluation and/or treatment
under either Chapter 394 or 397 F.S. (Baker Act/Marchman Act) who are transferred
between receiving facilities and local hospitals. The plan will ensure the coordination of
services among providers in Collier County and provide timely access to care for
persons experiencing a mental health/substance abuse crisis.
The benefit of a coordinated system of care is less fragmentation of services and a
more efficient and cost-effective method of providing transport. The plan would largely
eliminate transport by law enforcement, providing a more dignified, humane, and timely
method of transportation to and from acute care facilities. The plan also relieves law
enforcement of the responsibility to provide transport resulting in additional time
available for legitimate law enforcement activities.
Hillsborough and Sarasota County have implemented non-emergency transport plans
that bills an individual’s private insurance or Medicaid/Medicare. If the patient is indigent
the county pays for the transport. Collier County can utilize the design and experience
of these non-emergency plans in design of our non-emergency transport plan.
A Non-Emergency Transportation plan also frees up law enforcement to provide service
and safety to our community.
Goal: Whenever possible, the transportation of an individual under the Baker Act or the
Marchman Act from a medical facility to receiving facility will be completed by a non -
emergency transportation provider.
Objectives:
• Implement a transportation plan that utilizes non-emergency transportation
companies (Ambitrans, MediCab, David Lawrence Center approved staff, or
hospital-approved transportation) to transfer individuals being evaluated to
treated under the Baker Act or Marchman Act from a medical facility to a
receiving facility.
• Establish safety provisions that include appropriate medical equipment or safety
equipment to meet client needs
Formatted: Line spacing: Multiple 1.15 li
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• Establish appropriate level of supervision to ensure safety and prevent
elopement
Outcome/Impacts:
• Provide a dignified, humane, and streamlined method of transportation to and
from acute care facilities.
• Patient satisfaction with quality of care between receiving facilities
• Enhance the ability to fully utilize the capacity of acute care services in the
county and reduces the unnecessary delay of transfers between facilities.
• Reduce the time that law enforcement is diverted from its primary duties to
transport a person being evaluated or treated under the Baker Act or Marchman
Act between receiving facilities and local hospitals.
• Law enforcement and Collier County EMS will continue to transport Emergency
Baker Act or Marchman Act individuals to the appropriate receiving facility
• Enhanced continuity and care coordination among providers
Data elements required to assess outcome and impact:
• Collier County Sheriff's Office non-emergency Baker Act and Marchman Act
transport calls for service to David Lawrence Center
• Collier County Transportation Plan 2017-2020/Suncoast Region Substance
Abuse and Mental Health MOU
Workgroup: Lt. Leslie Weidenhammer (? Scott Burgess, Susan Kimper ?)
Formatted: Not Highlight
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Priority #6
Improve Community Prevention, and Advocacy, and Education Related to
Mental Health and Substance Use Disorders
Priority Statement:
Overview: Preventing mental health and/or substance use disorders and related
problems is critical to behavioral and physical health. Prevention and early intervention
strategies can reduce the extent and impact of mental and substance use disorders in
Collier County. Prevention approaches focus on helping people develop the
knowledge, attitudes, and skills they need to make good choices or change harmful
behaviors. Substance use and mental disorders can make daily activities difficult and
impair a person’s ability to work, interact with family, and fulfill other major life functio ns.
Mental illness and substance use disorders are among the top conditions that cause
disability in the United States. In addition, drug and alcohol use can lead to other
chronic diseases including diabetes and heart disease.
In 2017 11.2 million Americans 18 years or older had a serious mental illness and 19.7
million people reported having a substance use disorder in the past year. Many
individuals experiencing a diagnosable mental health or substance use disorder do not
know they have one and do not seek help. For almost all mental disorders, people delay
getting help, the median delay is 10 years, and of those who have been diagnosed with
a mental illness, only 41 percent of persons use mental health services in a given year.
Collaborative and coordinated community efforts to provide awareness, education,
prevention and advocacy are critical to reducing the stigma associated with and the
myths surrounding mental illness and substance use disorders. A greater understanding
of mental illness and substance use interventions can offer the community invaluable
information on availability and access to resources and better ways methods to support
those who may be experiencing these challenges. Implementation and supportive
delivery of evidence based educational opportunities will allow individuals, community
and family members and businesses to better identify when someone may be
experiencing mental health and substance abuse issues and seek help sooner.
Targeted public service information and resources around mental illness and substance
abuse will further contribute to stigma reduction and expand awareness of educational
opportunities offered in the community.
Formatted: Space After: 10 pt, Line spacing: Multiple 1.15
li
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Goal: Provide evidence basedevidence-based education and training on mental health
and substance use disorders to the community at large.
Objectives:
• Create an ongoing educational program that would certify community businesses
and organizations to increase knowledge and public awareness
• Make available ongoing education to 100% of the Collier population to increase
access and reduce stigma relation related to mental health and substance use
disorders
• Expand Mental Health First Training in the community
Outcomes/Impact:
• Develop prevention and education activities with Blue Zones or similar concept
• Increase knowledge and awareness of mental illness and substance use
disorders
• Increase awareness and access to resources and services
• Increased awareness and education can also increase availability of funding for
programs (private donor, grants, etc)
• Reduced rates of substance abuse and suicide in Collier; Increased percentage
of those experiencing symptoms of mental illness and/or substance abuse
enrolling in healthcare services.
Data elements required to assess outcome and impact:
• Number of participating or certified agencies in Collier County
• Number of educational programs provided
• Number of attendees
• Assess how the training was implemented
11.3.b
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Special Consideration #1
Improve Services to Veterans Experiencing
Mental Health and/or Substance Use Disorders
Overview: Veterans make up 13% (28,000) of our population in Collier County and an
estimated 2,500 are Post Gulf War Veterans. As a country, and community, we have a
responsibility to help these Veterans and their families, who from time to time are in
need of an array of programs and services that cannot be totally provided by the
Department of Veterans Affairs.Veterans Administration. Veterans receive the best
care when local communities work collaboratively with the VA to provide a variety of
supportive services. .
Within this population the most significant issues are Post Traumatic Stress Disorder,
Traumatic Brain Injury, military sexual trauma, and and Veteran suicide. Nationally
twenty (20) Veterans a day commit suicide, which is twice the rate of the non-veteran
population. In addition it is estimated that over 40% of Veterans are returning home
with PTSD & TBI. The primary reason is due to multiple tours of duty which are unique
to this generation of warriors, and the exposure to “Blast” trauma to the body. These
invisible wounds of war present create unique health and transitional issues for
Veterans, that result in mental health and substance abuse issues. The impact can be
devastating for the Veterans and their families.
There is a need in our community to design and implement services and programs to
meet the unique needs of our Veteran population.
Goal: Make the public and the veteran community aware of the transitional, mental
health, housing, and employment needs of post-combat veterans and mobilize
resources to address these issues for veterans and their families.
Objectives:
• Reduce veteran suicides – ensure that trackable data exists for Collier County
• Reduce veteran substance abuse – 274-500 Collier vets were treated by the VA
in 2018
• Reduce the number of veterans arrested in Collier County, currently
approximately 100 per year.
• Continue to keep accurate data on veterans who are homeless to advocate for
HUD-VASH vouchers
11.3.b
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• Increase the number of arrested veterans who are diverted to veteran treatment
court.
• Reduce the number of homeless veterans. A count conducted in July 2019
identified 40 homeless veterans living in Collier County.
• Include a social worker in the staffing of the Central Receiving Systemervices to
interact with and ensure that Veterans are linked with specialized services to
meet their unique needs.
• Employ a full time social worker or other liaison as part of the Collier County
Veterans’ Service Office responsible for coordination of mental health public
education, outreach to veterans and families, coordination with services at Bay
Pines, VA, Hunger and Homeless Coalition, Home Base and other service
providers.
• Increase access to combat related unique treatment – prolonged vs multiple
therapies.
• Educate and advocate on behalf of Veterans regarding size and demographics of
this group in our region.
• Make veterans and their families aware of and engaged in the programs and
services.
Data elements required to assess outcome and impact:
• Number of homeless veterans; number offered housing
• Number of veterans arrested annually;
• Number of veterans enrolled in treatment;
• Veteran treatment outcomes
Workgroup: Dr. Thomas Lansen, Dale Mullin
11.3.b
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Special Consideration #2
Increased Use of Evidence-based and Informed Approaches in all Mental Health
and Substance Use Disorder Related Programs and Services
Priority Statement: Increase use of evidence based and informed approaches in all
programs and services for persons with mental health and substance use disorders.
Overview: Evidence-based practice (EBP) began as a movement when the concept
was formally introduced in medicine in 1992. This represents an attempt to
systematically address the research–to-practice gap that exists in areas of clinical
practice, operations and policy-setting, leading to the adoption of more rigorous, proven
and effective methods. Since then, the methodology underlying EBP has been applied
to various allied health disciplines, along with spreading to other fields such as
management, education and law. When this occurs, the evidenced -base/informed
approaches implemented are often referred to as “best practices” in any given
application or field.
At its most basic level, EBP bases systematic decision-making-in operations and clinical
practice-on existing science to reduce variation, improve outcomes and reduce cost.
Moreover, wherever possible, it also takes into consideration critical population
parameters, extant values, preferences, and available resources, along with
environmental and organizational contexts relevant to EBP implementation. A distinction
is often drawn between “evidenced- based” practices, where the benefits of a process
or treatment are delivered under highly controlled conditions, versus “evidenced-
informed”, which describes the modification of EBP to be used under less ideal
circumstances. The latter represents the modal use of EBP practices and is regarded as
a sensible place to start when such ideal circumstances do not exist.
The Transdisciplinary EBP model (Satterfield et al., 2009) depicted below illustrates an
optimal process where decision-making (and clinical practice) takes all of these
variables in to account, against the backdrop of the best available research evidence, to
deliver context-relevant, “best practices”.
11.3.b
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Goal: Whenever possible, implement evidence based or informed practices and
services to enhance quality and cost effectiveness for targeted mental health and/or
substance use disorders programs and services.
Outcomes/impact: Patient-centered metrics
• Decreased symptoms per targeted disorder (e.g., anxiety, SUD, trauma) leading
to improved global functioning.
• Increased # of days of work for pay.
• Lower arrest/incarceration rates
• Decreased number and severity of medical co-morbidities (Congestive Heart
Failure, Diabetes);
• Decreased number and severity of negative social determinants of health
(housing, income, safety, education, access to health services)
• Increased patient satisfaction
Outcomes/impacts: Operational Metrics
• Increased training opportunities negotiated and initiated.
• Increased number of staff trained in evidence based treatment/practices.
• Ensure that evidenced-based tool kits are implemented as part of an ongoing
training program (”More than training”)
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• Increased number and percentage of clients (CLARIFY
Patient/Client/Consumer?)patients referred to evidence based treatment as
opposed to treatment as usual.
• Higher treatment adherence and completion rates of clientspatients in evidence
based treatment as opposed to treatment as usual.
• Lower “no show” rates in evidence based treatment as opposed to treatment as
usual.
• Increased number of clientspatients screened for various mental
health/substance use disorder problems.
• Decreased admission/readmission rates pre/post implementation of evidence
based practices.
• Reduced number of ED visits pre/post; length of stay in outpatient treatment;
medication compliance.
• Increased number of case management contacts with peer specialists and care
managers.
Data elements required to assess outcome & impact:
• Medical chart review
• Number of arrests/jail days using court records
• Work productivity/absenteeism – self report.
• SDOH registry – case manager
• ClientPatient satisfaction survey
• Internal provider agencies logs surveying all operational metrics.
Workgroup: Dr. Paul Simeone, Nancy Dauphinais Formatted: Not Highlight
11.3.b
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11.3.b
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Priority: _____Central Receiving Services_____ Logic Model
Goal: Ensure that there is a coordinated system and adequate capacity to assure that citizens in crisis will be able to acce ss emergency
mental health and substance use disorder services over the next 20 years.
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities Participation Short- 1 year Long 2-5 year
$25 Million for construction and
related capital purchases for
Central Receiving Services
structure(s)
$2-3 Million annual state and
local government appropriation
for Central Receiving Services
operations
Define terms and processes
regarding ownership, design,
construction and funding of
Central Receiving
Facility/Services/System
…For Discussion and
consistency Services
structure(s) and Furnishings,
Fixtures and Equipment.
Multiple activities related to
design and construction of
Central Receiving Services
structure(s) and identification
and procurement of FFE.
Develop an operational
budget and plan for
sustainable funding for
operations.
Collier County BOCC
and David Lawrence
Center
David Lawrence Center
Collier BOCC, Collier
Legislative delegation,
David Lawrence
Center.
Completion of all pre-
construction activities and
initiation of construction.
Submit a Legislative Budget
Request to partially fund
operations.
Secure funding from Collier
County to use as match to
support Legislative Budget
Request.
Completion of Construction.
Increased inpatient capacity
over baseline.
Central Receiving Services
utilized as single point of
access for persons in crisis
as a result of a Mental
Health and/or Substance
Use Disorder
Secure state funding and
matching county funds to
sustain Central Receiving
Services operations in
perpetuity.
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Priority: _____Housing and Supports________________ Logic Model
Goal: Increase availability and accessibility of a variety of housing options for persons with mental hea lth and substance use disorders.
Homelessness among persons with mental health and substance use disorders is rare, brief and one-time.
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities Participation Short- 1 year Long 2-5 year
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Packet Pg. 481 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
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Ch 420 F.S. re 10% set aside for
special pops
% of set aside to SAMH
Incentives: Landlords, builders,
developers
Non-profit developer
Affordable Housing units
Rental Vouchers
Individual’s income
Govt Funding (HUD)
Private Foundations
Benevolent Landlords
Supportive Services (Peer
Specialists, Case Management,
FACT)
SOAR providers/volunteers
Bridge Housing provider(s)
Peer Respite provider(s)
Collaboration structure and
process/MOU
Data Collaborative
$$ to execute plan
Legislative Advocacy
Community Education
Advocacy
Workforce Training EBP:
SH, SE, SOAR
Change prejudicial local
zoning language
SOAR applications
# Supported Employment
providers and # hours
#Supported Housing
providers and # hours
Peer (CRPS) supports
Implement Peer Run
Respite Home
Implement Bridge (< 3 mo.
emergency housing)
Grant Applications: Federal,
State, Local, public and
private
Tracking / reporting entry
into housing and services
programs
Homeless COC
State SAMH, Housing
HUD
County Housing and
Community Services
Board of County
Commissioners
State/Fed Legislators
Collier SAMH and
Housing agencies
Landlords
Developers / Builders
Employment agencies:
Goodwill, Vocl Rehab
Peers/CRPS
Law Enforcement/Jails
Judicial / Courts
Community members
Individuals/Families/Fri
ends
Media Advocates
County Approves % set aside
specific to SAMH
Discrimination / prejudicial
language in local zoning docs
# SMI on SSI/SSDI;
Medicaid/Medicare
MOU and Steering Committee
formed/active
# Community education
sessions, op eds, news
articles
Identify new non-profit
developer
# CRPS
# Providers and volunteers
trained in SE, SH, SOAR.
# SOAR applications
# days to enroll in
programs
# days to obtain
Transitional housing from
jail, hospital or
homelessness.
# days to obtain
permanent housing
# employed
# homeless SMI
0 Wait lists for housing and
services
0 New homeless in CoC PIT
count
Days in Community/
Housed (not hospital, jail,
shelter)
Days worked for pay
# on SSI/SSDI
# Homeless SAMH
Accessing
emergency/Bridge housing
# days in Bridge housing =
< 180
# Days Housing and
Services Retention/LOS
11.3.b
Packet Pg. 482 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
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Priority: _____Data Collaborative______ Logic Model
Goal: Create a data collaborative that will collect and analyze data from all stakeholders that provide services to persons experiencing a
mental health and/or substance use disorder and use that information to continuous improve program quality and patient outcom es.
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities –
What we will do Participation Short- 1 year Long 2-5 year
Assignment of county staff to
provide leadership and direction
to development of the data
collaborative.
Identify and secure participation
of essential governmental, non-
profit and for profit organizations
to participate in and share data
with the collaborative
Identify and recruit data
collaborative members
Define data elements to be
collected and shared by
collaborative members
Define standard reports,
reporting frequency, and
mechanism of report
distribution.
Data collaborative members
utilize shared data to identify
and report on emerging
issues related to program
quality and patient outcomes.
Data collaborative members
utilize shared data to provide
data for grant opportunities
and new programming
Active participation by
75% or more of
recruited members.
100% of data elements
and collected and
shared by collaborative
members.
100% of Standard
reports are prepared
and distributed on time.
Analysis of data to
identify trends and
emerging issues is
reviewed and reported
by data collaborative
members at least
annually.
Data collected and
reported by data
collaborative is used 4
or more times annually
in materials prepared in
response to funding
opportunities or to
justify new or revised
programming.
Data Collaborative is organized,
meeting, collecting data and
issues a baseline report on data
collected.
Data Collaborative releases
data according to a
schedule agreed upon by all
members.
Data Collaborative identifies
at least one emerging issue
annually.
Data Collaborative provides
data that assists in
obtaining new funding or
reinvestment of existing
funding to address
emerging community needs
in mental health and
substance use disorder
treatment.
11.3.b
Packet Pg. 483 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
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Priority: _____Justice System Response________________ Logic Model
Goal: Expedite deflection and diversion of persons with mental health and/or substance use disorders prior to arrest and from jail to
treatment, thereby reducing recidivism, improving community safety and directing resources to optimize outcomes.
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities Participation Short- 1 year Long 2-5 year
Pre-Arrest Diversion
Educate Law Enforcement
Expand Mental Health Unit
Increase capacity of treatment
providers
Jail Diversion
Implement Medication Assisted
Treatment at Collier County Jail.
Expand Project Recovery
Increased number of community
based and in jail mental health
and substance use counselors
Develop alternative in-jail
treatment program for inmates
already receiving Medication
Assisted Treatment prior to
incarceration.
Expand court ordered assisted
outpatient treatment to circuit
court.
Utilize Mental Health Unit to
train road deputies in
deflection processes.
Seek CJMHSA Reinvestment
Grant funding to implement
Medication Assisted
Treatment in the County Jail.
Seek County, State and
Federal funding to support
additional judicial and
treatment team positions for
court based diversionary
programs including drug
court, veteran’s court and
assisted outpatient
treatment.
Mental Health Unit,
Collier Sheriff’s
Deputies, David
Lawrence Center staff
Criminal Justice
Planning Council
Collier Legislative
delegation, Collier
County government,
U.S. Department of
Justice, U.S.
Department of Health
and Human Services,
private foundations.
# of law enforcement trainings
provided.
Decrease in arrests for drug
possession.
Increase in number of referrals
to treatment directly from law
enforcement.
Increase in the number of
treatment referrals either in
custody or through transfer to
community based programs.
Decrease in jail days for inmates
whose crimes are directly
related to their mental health
and substance use disorders.
Decrease in recidivism among
inmates who participate in jail
diversion programs.
Continued decrease in
possession arrests and
continued increase in
number of referrals to
treatment year over year.
Quicker response team in
diverting from jail or
enrolling in jail based
programs.
Year over year decreases in
recidivism among inmates
who participate in jail
diversion programs.
Year over year Increases in
the number of treatment
referrals either in custody or
through transfer to
community based
programs.
11.3.b
Packet Pg. 484 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
35
Priority: ____Non-Emergency Baker Act/Marchman Act Transportation___ Logic Model
Goal: Whenever possible, the transportation of an individual under the Baker Act or the Marchman Act from a medical facility to
receiving facility will be completed by a non-emergency transportation provider.
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities Participation Short- 1 year Long 2-5 year
Transportation Workgroup
consisting of involved partners –
CCSO, Collier County
Government, David Lawrence
Center, NCH, XXX, XXX, XXX
Funding to support
transportation plan and costs of
transport vehicles and drivers.
Develop answers to the who,
what, when and where
questions that will drive the
structure of the transportation
agreement.
Prepare a cost analysis that
includes current costs for all
partners, the annual number
of transports provided, the
annual number of patients
transported and a projection
of future need.
Develop a share cost
agreement among partners
to be either included in the
Transportation Plan or
included by reference in the
plan
Transportation
Workgroup
Transportation
Workgroup
Transportation Plan written and
signed off by all partners.
Identification of Transportation
Provider or Providers
Cost sharing agreement
developed and signed off by all
partners.
Law enforcement agencies
no longer providing non-
emergency transport except
in cases of unstable
individuals at high risk to
harm self or others.
Increased patient
satisfaction regarding
quality of care in
transportation.
Law enforcement agencies
re-allocate time previously
spent in transportation to
other public safety activities.
Transportation Contract (s)
in force and functioning.
Transportation Workgroup
continues to meet to review
data and address any inter-
agency issues that may
develop.
11.3.b
Packet Pg. 485 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
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Priority: _____Prevention________________ Logic Model
Goal: Provide evidence based education and training on mental health and substance use disorders to the community at large.
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities Participation Short- 1 year Long 2-5 year
Identify collaborative agencies
and personnel that provide
evidence based prevention
programs.
Identify evidence based
programs available.
Participation in Task Force for
App development
(mh/substance use inclusion
PSA – Awareness avenues –
identify social media print
materials.
Chamber of Commerce
Develop Collaborative Partners
in Prevention
Develop speaker’s bureau
Assist in local prevention App
development
Development or identification of
plan and materials
Develop resource center that
can provide materials and
programs to the community.
Drug Free Collier
NAMI
Mental health providers
Collaborative group of providers
for education
Participation Task Force
provides training for agencies
and community responders
Identify funding
Linkage with print and electronic
media
Funding and staffing to
support education and
prevention
Relationship to 211.
App implementation
increased access to
recovery services
Awareness
Prevention/Education
campaigns
11.3.b
Packet Pg. 486 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
37
Placeholder for Veterans Logic Model
11.3.b
Packet Pg. 487 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
38
Priority: _____Evidence Based Practice________________ Logic Model
Goal: Whenever possible, implement evidence based or informed practices and services to enhance quality and cost effectiveness for
targeted mental health and/or substance use disorders
Inputs Required
(Resources)
Outputs Outcomes -- Impact
Activities Participation Short- 1 year Long 2-5 year
11.3.b
Packet Pg. 488 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
39
Trauma Informed Care
Funding for training
Qualified trainers
Engaged and committed staff
and provider agencies
Assertive Community
Treatment
Increased state funding to
support Collier County’s 100
person team.
Funding for a second team for
early intervention
Medication Assisted
Treatment
Funding for Medication and
Services through CJMHSA
Reinvestment Grant
Qualified workforce
Legislative Budget Request
to increase funding levels for
all Florida FACT Teams
Fidelity to ACT program
model
Seek funding through
Reinvestment Grant funding
in 2020.
# of credentialed
trainers and
practitioners
# of trained staff
# of clients referred to
trauma informed care
# of
participants/completers
Collier Legislative
Delegation, Florida
Department of Children
and Families
David Lawrence Center
Criminal Justice
Planning Council
Increased rates of treatment
retention and completion.
Reduced ED visits,
treatment readmission
rates, and length of stay.
Increased medication
adherence and access to
and utilization of case
management services.
Increased levels of
functioning as measured by
standardized assessments
and performance measures.
Reduced incarceration and
inpatient admissions.
Improved global
assessment of functioning.
Medication adherence
Reduced ED visits and
overdoses.
Reduced admissions to
inpatient treatment.
Decreased symptoms and
improved global
assessment of functioning.
Priority: _____ Evidence Based Practice (cont)_______________ Logic Model
Goal: Whenever possible, implement evidence based or informed practices and services to enhance quality and cost effectivene ss for
targeted mental health and/or substance use disorders
Inputs Required Outputs Outcomes -- Impact
11.3.b
Packet Pg. 489 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
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(Resources) Activities Participation Short- 1 year Long 2-5 year
Supportive Employment
Trainers/Training in Supportive
Employment practices from
Pathways to Work and Goodwill
Industries.
Peer Services
Engaged peers able and willing
to be employed as certified peer
specialists.
Support peers in navigating
background clearance barriers.
Steady funding to enable
agencies to employ peer
specialists.
Diversion/Deflection
Mental Health Intervention Team
Mobile Crisis Response Team
Crisis Intervention Training
Licensed Professionals for
Assessment and Referral
Case Managers and Peers
Training activities negotiated
and presented according to a
an annual training schedule
Peer specialist recruitment.
Advocacy provided to assist
peers who encounter
difficulty obtaining
background clearance due to
criminal history or other
barriers.
Pathways to Work,
Goodwill Industries.
Increased number of
trained supportive
employment specialists
Increased number of
participants receiving
supportive employment
services.
Provider agencies
Provider agencies
Review, reinvestment of
current state, federal
and local dollars to
provide mental health
and substance use
disorder treatment
# of individuals diverted
# of follow up contacts
with at-risk individuals
Training activities negotiated
and initiated
Increased number of certified
peer specialists.
Increased number of client
contacts with certified peer
specialists.
Increased number of days
worked for pay among
those participants who
treatment plans include
supportive employment
services.
Increased treatment
adherence, retention in
treatment and completion
rates among those
participants supported by a
peer specialist.
Decreased treatment
readmission rates for those
participants supported by a
peer specialist.
Reduced frequency of
opioid overdose, ED visits
and admissions to inpatient.
Reduced drug related crime
Decreased symptomatology
and improved global
assessment of functioning.
Increase in # of days
worked for pay.
11.3.b
Packet Pg. 490 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County
Mental Health and Addiction Ad Hoc Committee Meeting
(as of September 2019)
Committee Membership
Filled Positions
Membership Credential Committee Member Organization
1 Veterans Service Organization Dale Mullin Wounded Warriors of Collier
2 Collier County Sheriff’s Office Lt. Leslie Weidenhammer CCSO
3 Licensed Psychiatrist/Psychologist Dr. Paul Simeone Lee Health
4 Licensed Behavioral Health Prof. Susan Kimper NCH
5 Medical Health Professional Dr. Thomas Lansen
6 David Lawrence Center Scott Burgess DLC
7 NAMI Dr. Pam Baker NAMI
8 At-large Honorable Janeice Martin 20th Judicial Circuit
9 Collier County Grantor Agency Robert Saunders
10 Homeless Advocacy Organization Michael Overbay Hunger & Homeless Coalition
11 Peer Specialist CM Michelle McLeod City of Naples
12 Recovery Community Janice Rosen
13 At-large Dr. Michael D’Amico
14 At-large Caroline Brennan Collier County Public Schools
15 At-large Russell Budd PBS Contractors
16 At-large Pat Barton
17 At-large Dr. Jerry Godshaw
18 At-large Trista Meister Mindful Marketing
Vacant Positions
Membership Credential Committee Member Organization
At-large (1) Vacant
Item 8.2 - Existing Committees and Future Recommendations
11.3.b
Packet Pg. 491 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County Mental Illness and Addiction Ad Hoc
COLLIER COUNTY
PUBLIC SAFETY COORDINATING COUNCIL
ROSTER OF MEMBERS
(As of July 2019)
Membership
Type
Name Title
1. Statutory Member Commissioner
Burt Saunders
Commissioner, Board of County
Commissioners and PSCC Chairman
2. Statutory Member Sheriff
Kevin Rambosk
Sheriff, Chief Correctional Officer
Sheriff ‘s designee if unable
to attend
Chief Chris Roberts Sheriff’s Office – Jail Administrator
3. Statutory Member Chief Judge
Michael T. McHugh
Chief Circuit Judge
4. Statutory Member Judge Rob Crown
County Court Judge
5. Statutory Member Amira Fox State Attorney, 20th Judicial Circuit
State Attorney’s designee if
unable to attend
Nicole Mirra State Attorney’s Office-Collier
County
6. Statutory Member Kathy A. Smith
Public Defender, 20th Judicial Circuit
Public Defender’s designee
if unable to attend
Rex Darrow Supervising Assistant Public
Defender
7. Statutory Member
Terri McCall
State Prob. Circuit Administrator
State Probation
Administrator’s designee if
unable to attend
Robin Kelly Senior Supervisor
State Probation
8. Statutory Member Jeff Nichols Director of County Probation
County Probation Director’s
designee if unable to attend
Juan Ramos Collier Probation
9. Statutory Member Scott Burgess Executive Director, David Lawrence
Center
DLC Executive Director’s
designee if unable to attend
Nancy Dauphinais David Lawrence Center, Chief
Operating Officer
10. Statutory Member
Joe Paterno Executive Director-Southwest
Florida Workforce Dev.
Non-voting participant Crystal K. Kinzel Clerk of the Circuit Court &
Comptroller for Collier County.
Non-voting participant Mike Sheffield Director, Collier Communications
Non-voting participant Katina Bouza
Director,
Corrections Support Division- CCSO
Non-voting participant Judge Janeice Martin
County Court Judge
11.3.b
Packet Pg. 492 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County Mental Illness and Addiction Ad Hoc
Criminal Justice Mental Health Substance Abuse (CJMHSA)
Planning Council
Member Organization
Eric Townsend Public Defender’s Office
Amanda Krause State Attorney’s Office
Beverly Belli David Lawrence Center
Bianca Borges David Lawrence Center
Cindy Highsmith National Alliance on Mental Illness
Chief Chris Roberts Collier County Sheriff’s Office
Connie Kelley Public Defenders’ Office
Dawn Whelen Community & Human Services (County)
Tami Bailey Community & Human Services (County)
Michael Overway Hunger & Homeless Coalition
Heather Davis Veteran Justice Outreach Program
Jennifer Campo Collier County Sheriff’s Office
Julie Franklin Shelter for Abused Women and Children
The Honorable Janiece Martin 20th Judicial Circuit
Jeff Nichols County Probation
Juan Ramos County Probation
Katie Burrows David Lawrence Center
Katina Bouza Collier County Sheriff’s Office
Kerri Miller David Lawrence Center
Sheriff Kevin Rambosk
Kristi Sonntag Community & Human Services (County)
Lt. Leslie Weidenhammer Collier County Sheriff’s Office
Laura Ferrell State Attorney’s Office
Lois Bollin SWFL Vets Alliance
Marien Ruiz Collier County Sheriff’s Office
Mark Englehardt USF
Michael Lisboa CCSO
Michael Sheffield Collier County Administration
Robin Eckenroth CCSO
Monique Nagy CCSO
Nancy Dauphinis David Lawrence Center
Nicole Mira State Attorney’s Office
Pam Baker NAMI
Peter Arvin State Probation
Darrow Rexford Public Defender’s Office
Scott Burgess David Lawrence Center
Susan Vivonetto CCSO
Tyrone Davis Naples Police Department
Traci Foss Dept. of Juvenile Justice
Barbaro Baez-Alvarez NAMI
Dareece Canady CCSO
Michelle Rubbo Community & Human Services (County)
Kylie Sumner CPE
11.3.b
Packet Pg. 493 Attachment: [Linked] Agenda and Back-up Document Packet - October 08, 2019 (11025 : Collier County Mental Illness and Addiction Ad Hoc